1. Field of the Invention
This invention relates to electrosurgical appliances, and more specifically to a debris and electrolyte fluid purging electrosurgical device suitable for use with an arthroscopic system.
2. Information Disclosure Statement
The surgery accomplished by the use of electricity has progressed dramatically since the first introduction many years ago. Electrosurgery was first discovered to cause a "carbonization" or a cutting of a tissue when an electrosurgical electrode was located adjacent the tissue and to cause a "coagulation" of a tissue when the electrosurgical electrode was contacting a lesion or tissue. With the improvement of electrical generators, the discovery was made that a different type of electrical generator wave forms performed a different type of function on the lesions or tissues. A first or a moderately dampened wave form performs a strictly cutting function whereas a second or a substantially dampened wave form also performs a coagulation function. A third or a blended wave form combines the effect of cutting and coagulation although both the cutting and coagulation effects are somewhat diminished form the pure effects of coagulation and cutting.
Certain design changes have occurred for improving the electrical exposure of the electrode tip. These design changes were brought about by the understanding that electrical energy is dissipated from the electrode tip where the exposure of the electrode tip is large relative to the surgical site or where the exposure of the electrode tip is immersed in an operative site which is an electrically conductive environment because of electrically conductive fluids and the like. It was also learned that a larger exposed area of an electrode tip would require more power and be less efficient since there was a lower energy concentration. Furthermore, it was discovered that certain ionic solutions would also enhance the electrical dissipation from the electrode tip. For example, local anesthetics administered in a sodium chloride diluent infiltrated into the tissue and diminished the electrosurgical effects of the electrode tip. The presence of the sodium chloride enhanced the dissipation of the electrical energy. Accordingly, local anesthesia is not recommended in electrosurgical procedures. The electrical conductivity of blood will also interfere in the efficacy of the electrosurgical apparatus. The presence of the sodium chloride in the blood will cause dissipation of the electrical energy at the electrode tip. As a remedy to this problem, electrosurgical procedures require an irrigating solution with the irrigating solution is electrically non-conductive or non-ionic in nature. Therefore, during the surgical procedure, the presence of blood would necessitate the further irrigation of the operative site by an electrical non-conductive irrigation medium. A benefit of irrigating the site is that the involved area is distended allowing for better visibility of the injured area. Generally, sterile distilled water is used as the electrical non-conductive irrigation medium. However, other fluids such as air or carbon dioxide may sometimes be used in place of water. Air or carbon dioxide further provide distention of the knee joint during the surgical procedure to enable improved irrigation of the surgical site. However, the use of air or carbon dioxide is extremely dehydrating to the articular cartilage. Furthermore, carbon dioxide is extremely dehydrating and may unite with water present at the surgical site to form carbonic acid. Solutions of glycine or sorbitol are electrically non-conductive but are very viscous and can obscure the visual field of the surgical site.
Although the aforementioned prior art disclosures have aided in the development of electrosurgery, none of the aforementioned advances has satisfied the needs in the treatment and management of joint disorders in orthopedic practice. The use of arthroscopy in orthopedic practice has enabled orthopedic surgeons to directly visualize injury and disease sites and correct conditions with minimal incisions which only a few years ago would require an extensive open incision. However, the advent of arthroscopic surgery in the orthopedic practice has posed new problems to the manufacture of electrosurgical equipment. Among the most difficult problems in arthroscopic electrosurgery is the control of the conductive surgical environment of the surgical site within which the electrode tip must function. Present procedures utilize an electrically conductive isotonic solution, such as normal saline, to distend the surgical area in order to visualize the area. If electrosurgery is indicated, irrigation with an electrically conductive solution is terminated and irrigation with a non-electrically conductive solution is initiated.
It is a primary objective of this invention to provide an apparatus which overcomes the aforementioned difficulties of the prior art devices and provides an improvement which is a substantial contribution to the advancement of the electrical surgical electrode art.
Another object of this invention is to provide a fluid purging electrosurgical device which enables a surgeon to electrosurgically operate at an operative site which is contemporaneously irrigated by an electrically conductive solution such as normal saline or the like.
Another object of this invention is to provide a fluid purging electrosurgical device which is electrically operable in areas that are highly electrically resistant such as the meniscus cartilage and fat tissue.
Another object of this invention is to provide a fluid purging electrosurgical device which is applicable to many types of surgical operations but is specifically designed for arthroscopic surgery.
Another object of this invention is to provide a fluid purging electrosurgical device comprising an electrically conductive electrode tip which is electrically connected to a power source and which is in fluid communication with a fluid source to enable the electrode tip to be enveloped in a non-electrical conducting fluid thereby providing a non-electrical conductive and debris free operative site.
Another object of this invention is to provide a fluid purging electrosurgical device which is insulated and fluid tight.
Another object of this invention is to provide a fluid purging electrosurgical device wherein debris adjacent the operative site is forced from or purged from the operative site by the force of the purging electrically non-conductive fluid emanating from the duct means proximate the electrode tip.
Another object of this invention is to provide a fluid purging electrosurgical device with a fluid port which is integrally formed in the insulating means.
Another object of this invention is to provide a fluid purging electrosurgical device wherein the electrode tip and a region immediately proximate the electrode tip are enveloped in an electrically non-conductive fluid to enable electrosurgery with the enveloped electrode tip at a surgical site otherwise including the presence of electrically conductive fluids.
Another object of this invention is to provide a fluid purging electrosurgical device to prevent encroachment of an electrically conductive irrigation solution while minimizing any potential osmotic tissue damage to the irrigated operative site.
Another object of this invention is to provide a fluid purging electrosurgical device to prevent encroachment of debris and electrically conducting fluids proximate the electrosurgical site to enable the performance of the desired electrosurgical procedure.
Another object of this invention is to provide a fluid purging electrode which increases the efficiency of the electrosurgical operation by displacing of the normally present electrically conductive fluids and electrically conductive isotonic irrigation solution from the surgical site to enable concentration of the electrical energy of the electrode tip at the desired surgical site.
The foregoing has outlined some of the more pertinent objects of the present invention. These objects should be construed be to be merely illustrative of some of the more prominent features and applications of the invention. Many other beneficial results can be obtained by applying the disclosed invention in a different manner or modifying the invention within the scope of the invention. Accordingly, other objects and a fuller understanding of the invention may be had by referring to the summary of the invention and the detailed description describing the preferred embodiment in addition to the scope of the invention defined by the claims taken in conjunction with the accompanying drawings.